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Exhibit ES-4. Cumulative Impact on National Health Expenditures (NHE) of Insurance Connector Approach Plus Selected Individual Options Dollars in billions.

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Presentation on theme: "Exhibit ES-4. Cumulative Impact on National Health Expenditures (NHE) of Insurance Connector Approach Plus Selected Individual Options Dollars in billions."— Presentation transcript:

1 Exhibit ES-4. Cumulative Impact on National Health Expenditures (NHE) of Insurance Connector Approach Plus Selected Individual Options Dollars in billions Note: Selected individual options include improved information, payment reform, and public health. Source: Based on projected expenditures absent policy change and Lewin estimates. Savings to NHE

2 Exhibit ES-5. Total National Health Expenditures, 2008–2017 Projected and Various Scenarios * Selected individual options include improved information, payment reform, and public health. Source: Based on projected expenditures absent policy change and Lewin estimates. Dollars in trillions

3 Exhibit 1. Projected National Health Expenditures (NHE) by Payer Source, 2005–2016 * Consumer payments include out-of-pocket payments and private health insurance. Source: J. A. Poisal, C. Truffer, S. Smith et al., Health Spending Projections Through 2016: Modest Changes Obscure Part Ds Impact, Health Affairs Web Exclusive (Feb. 21, 2007):w242–w253.

4 Exhibit 2. International Comparison of Health Spending, 1980–2005 Source: OECD Health Data 2007. Average spending on health per capita ($US PPP) Total health expenditures as percent of GDP

5 Exhibit 3. Financial Burden for Low- and Middle-Income Families Is Increasing Percent of nonelderly adults spending 10% or more of disposable income on family out-of-pocket medical costs and premiums Note: Financial burden includes out-of-pocket costs for premiums for private insurance and other health services. Source: J. S. Banthin and D. M. Bernard, Changes in Financial Burdens for Health Care: National Estimates for the Population Younger than 65 Years, Journal of the American Medical Association, Dec. 13, 2006 296(22):2712–19.

6 Exhibit 4. One-Third of Adults Ages 19–64 Are Uninsured or Underinsured, as Are Two-Thirds of Low-Income Adults * Underinsured defined as insured all year but experienced one of the following: medical expenses equaled 10% or more of income; medical expenses equaled 5% or more of incomes if low-income (<200% of poverty); or deductibles equaled 5% or more of income. Data: 2003 Commonwealth Fund Biennial Health Insurance Survey (Schoen et al. 2005b). Source: Commonwealth Fund National Scorecard on U.S. Health System Performance, 2006. Percent

7 Exhibit 5. Growth in National Health Expenditures (NHE) Under Various Scenarios Source: The Commonwealth Fund; data from J. A. Poisal, C. Truffer, S. Smith et al., Health Spending Projections Through 2016: Modest Changes Obscure Part Ds Impact, Health Affairs Web Exclusive (Feb. 21, 2007):w242–w253. NHE, in trillions of dollars 7 $1.99 T in 2005 Cumulative savings projections to 2016: One-time savings of 5%: $1.56 trillion Slowing trend by 1% annually: $1.72 trillion Combination of one-time savings and slowing trend: $3.19 trillion $4.14 T $3.93 T $3.77 T $3.58 T (19.6% GDP) (18.6% GDP) (17.8% GDP) (16.9% GDP)

8 Exhibit 8. Distribution of 10-Year Impact on Spending from Promoting Health Information Technology Dollars in billions SAVINGS COSTS Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007.

9 Exhibit 9. Distribution of 10-Year Impact on Spending from Center for Medical Effectiveness and Health Care Decision-Making Dollars in billions SAVINGS COSTS Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007.

10 Exhibit 10. Distribution of 10-Year Impact on Spending from Patient Shared Decision-Making Dollars in billions SAVINGS COSTS Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007.

11 Exhibit 11. Distribution of 10-Year Impact on Spending from Reducing Tobacco Use Dollars in billions Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007. SAVINGS COSTS

12 Exhibit 12. Distribution of 10-Year Impact on Spending from Reducing Obesity Dollars in billions SAVINGS COSTS Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007.

13 Exhibit 13. Distribution of 10-Year Impact on Spending from Positive Incentives for Health Dollars in billions Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007. SAVINGS COSTS

14 Exhibit 14. Distribution of 10-Year Impact on Spending from Hospital Pay-for-Performance Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007. Dollars in billions SAVINGS COSTS

15 Exhibit 15. Distribution of 10-Year Impact on Spending from Episode-of-Care Payment Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007. Dollars in billions SAVINGS COSTS

16 Exhibit 16. Distribution of 10-Year Impact on Spending from Strengthening Primary Care and Care Coordination Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007. Dollars in billions SAVINGS COSTS

17 Exhibit 17. Distribution of 10-Year Impact on Spending from Limit on Federal Tax Exemptions for Premium Contributions Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007. Dollars in billions SAVINGS COSTS

18 Exhibit 18. Distribution of 10-Year Impact on Spending from Reset Benchmark Rates for Medicare Advantage Plans Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007. Dollars in billions SAVINGS COSTS

19 Exhibit 19. Distribution of 10-Year Impact on Spending from Competitive Bidding Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007. Dollars in billions SAVINGS COSTS

20 Exhibit 20. Distribution of 10-Year Impact on Spending from Negotiated Prescription Drug Prices Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007. Dollars in billions SAVINGS COSTS

21 Exhibit 21. Distribution of 10-Year Impact on Spending from All-Payer Provider Payment Methods and Rates Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007. Dollars in billions SAVINGS COSTS

22 Exhibit 22. Distribution of 10-Year Impact on Spending from Limit on Payment Updates in High-Cost Areas Source: Based on estimates by The Lewin Group for The Commonwealth Fund, 2007. Dollars in billions SAVINGS COSTS

23 Exhibit 23. Cumulative Changes in Annual National Health Expenditures, 2000–2007 Notes: Data on premium increases reflect the cost of health insurance premiums for a family of four/the average premium increase is weighted by covered workers. * 2006 and 2007 private insurance administration and personal health care spending growth rates are projections. Sources: A. Catlin, C. Cowan, S. Heffler et al., National Health Spending in 2005: The Slowdown Continues, Health Affairs, Jan./Feb. 2007 26(1):143–53; J. A. Poisal, C. Truffer, S. Smith et al., Health Spending Projections Through 2016: Modest Changes Obscure Part Ds Impact, Health Affairs Web Exclusive (Feb. 21, 2007):w242–w253; Henry J. Kaiser Family Foundation/Health Research and Educational Trust, Employer Health Benefits Annual Surveys, 2000–2007 (Washington, D.C.: KFF/HRET). 109% 65% 91% 24% Percent change

24 Exhibit 24. Cumulative Impact on National Health Expenditures (NHE) of Insurance Connector Approach Plus Selected Individual Options Dollars in billions Note: Selected individual options include improved information, payment reform, and public health. Source: Based on projected expenditures absent policy change and Lewin estimates. Savings to NHE

25 Exhibit 25. Net Federal Spending with Insurance Connector Alone Compared with Net Federal with Insurance Plus Savings Options Dollars in billions * Selected options include improved information, payment reform, and public health. Source: Lewin Group modeling estimates of insurance option alone or insurance in combination with savings options compared with projected federal spending under current policies. $82 Insurance Alone $122 Insurance Alone $205 Insurance Alone

26 Exhibit 26. Total National Health Expenditures, 2008–2017 Projected and Various Scenarios * Selected individual options include improved information, payment reform, and public health. Source: Based on projected expenditures absent policy change and Lewin estimates. Dollars in trillions

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